UMass Worcester PRC Publications


Alignment of stakeholder agendas to facilitate the adoption of school-supervised asthma therapy

UMMS Affiliation

Department of Pediatrics, Division of Pediatric Pulmonology; Department of Population and Quantitative Health Sciences; Department of Psychiatry; UMass Worcester Prevention Research Center; Implementation Science and Practice Advances Research Center

Publication Date


Document Type



Behavioral Medicine | Community Health and Preventive Medicine | Health Services Administration | Immune System Diseases | Pediatrics | Preventive Medicine | Pulmonology | Respiratory Tract Diseases | Therapeutics


BACKGROUND: School-supervised inhaled corticosteroid (ICS) therapy improves pediatric asthma medication adherence, outcomes, and morbidity. However, school-supervised ICS therapy has not been widely adopted into practice. We developed Asthma Link as a sustainable, low-cost model of school-supervised asthma therapy, designed for real-world adoption. Initial outcomes of Asthma Link demonstrated a significant improvement in health outcomes.

OBJECTIVE: In this study, we examined the perspectives of Asthma Link participants to identify systems-level barriers and facilitators to refine the Asthma Link protocol and facilitate real-world uptake of school-supervised asthma therapy.

METHODS: Using qualitative research methods, we interviewed 29 participants in Asthma Link from 2016 to 2018. Semi-structured interviews were conducted over the phone. Interviews were transcribed and the transcripts were coded to identify major themes within and across stakeholder groups.

RESULTS: Stakeholders agreed on many facilitators for successful Asthma Link execution including the brief and easy to follow procedures and the perceived beneficial health impacts for children involved. Some of the barriers identified were deviations from the protocol and insurance companies denying coverage for two inhalers. However, the participants did propose solutions to address these barriers.

CONCLUSION: Asthma Link is a low-cost, sustainable model of school-supervised asthma therapy that leverages the established infrastructure and collaboration of medical providers, school staff, and families. In this study, we elicited the perspectives from these stakeholder groups and identified an agreement in several facilitators, barriers, and proposed solutions that will ultimately inform refinement of the program protocol and support real-world adoption of Asthma Link and other similar models.


daily inhaled corticosteroid, pediatric asthma, qualitative study, stakeholder perspectives, UMCCTS funding

DOI of Published Version



Trivedi M, Patel J, Hoque S, Mizrahi R, Biebel K, Phipatanakul W, Lemon SC, Byatt N, Gerald LB, Rosal M, Pbert L. Alignment of stakeholder agendas to facilitate the adoption of school-supervised asthma therapy. Pediatr Pulmonol. 2019 Dec 19;10.1002/ppul.24611. doi: 10.1002/ppul.24611. [Epub ahead of print]. PMID: 31856415. Link to article on publisher's site

Journal/Book/Conference Title

Pediatric pulmonology

Related Resources

Link to Article in PubMed

PubMed ID